Opening with ACT

1. Opening with ACT

2. Informed Consent • This training is experiential in nature: • Designed this way to increase understanding of the theory and to help clinicians contact the core of the work • May stir a few things up • What might that look like…. • Your privacy will never be violated, but you will be invited to take risks. • For that reason we must agree to confidentiality

3. Engaged Processes OpenProcesses Aware Processes

4. “Confronting the Agenda” • Purpose: To increase awareness of the presence and functioning of any unworkable “Control” strategies. • Method: 1. Draw out and naming attempts that have been used to make things better. 2. Examine if they have truly worked to make the client’s life better. (“Workability”) 3. Discuss the typical outcome of the “Control” Agenda. • Goal: To loosen attachment to old unworkable patterns, and develop willingness to engage in new strategies.

5. “Control” strategies targeted by ACT? • Any Control strategy that begins to move us away from what is most important to us? (“Unworkability”) • Likely Unworkable “Control” Strategies include: Distraction: Staying Busy, TV/online/phone, misusing mindfulness Opting Out: Withdrawal, Isolation, Sleep, Zoning out, “I don’t know. “ Thinking: Blaming, Worrying, What if ?, Why Me?, “Should”, Fantasizing Substances/Self-Harm: Food and Risky Behavior too.

6. Today’s Fellow Traveler • Endearing Client’s Name: • Problem Area: • Attempts to solve the Problem:

7. Drawing out “control” strategies • A few core questions asked non-judgmentally, patiently and without coercion: • What attempts have you made to handle this? • What have been the results? • What has it cost you? • Has it made your life better or worse overtime? • When you look at these things you have been trying and how they have worked out, what does it seem like to you? • If unworkable: “ For the purposes of our work, would you be willing to put this on the list of things that hasn’t helped.

8. “Control” as the problem. • Control as a problem Exercise Pushing Hand or Clipboard • Metaphors: Quicksand, Feed the Baby Tiger, Tug of War • Illustrating the Illusion of Control Exercises Don’t Think about a Yellow Jeep Have you ever had thoughts/feelings you didn’t act on?

9. The “A” in ACT: Acceptance • Goal: Being willing to experience painful internal and external experiences, as they are, when doing so allows us to move toward what is most important to us? • To prevent uneccessary suffering and increase valued living. • The word “Willingness” is often used in place of Acceptance. Willingness is not: Liking, Resignation or Wanting Willingness is a: Choice, Stance and Action

10. Introducing Willingness • Normalize Painful Private Experiences: This confirms that you are a human being who has a live, beating heart and who cares about something. • Allowing: See if you can allow that ____________to be there. • Compassion: Try to hold this as something worth taking care of. • The Choice to Have it If having this means you get to do what matters most to you, would you be willing to have it? • Metaphors: Two sides of Life, Struggle Switch • Noticing/Observing: Present Moment Awareness (Mindfulness)

11. Defusion “The fundamental challenge of being human involves learning when to follow what your mind says and when to simply be aware of your mind while attending to the here and now.” -Hayes, 2012

12. Defusion vs. Fusion • Fusion: Getting caught up in our thoughts in a way that we can’t distinguish a thought from the direct experience. (Looking from our thoughts). • Defusion: Process of recognizing our thoughts as they are, instead of what they say they are. (Looking at thoughts) • Goal of Defusion • See the limitations of our thought processes. (Internal Verbal Evaluations vs. Direct External Events) • Respond to thoughts in terms of workability rather than literality. (How helpful is this in the Here and Now? rather than how true is this?) ( Harris, 2009, “ACT Made Simple”)

13. Defusion Processes • Allowing (Looking at function, not challenging form/structure.) • The Mind as an Entity (Treating the “mind” as an entity that continuously commentates about life) • Thoughts as Stories: (“The master story teller” metaphor) • Writing Thoughts Down (Index cards, journaling, labels, etc. ) • Mindfulness Exercises

14. The “Mind” as an Entity • Question Examples: So What’s your mind telling you now? What do you get when you buy that thought? Who’s talking here you or your mind? • Characterizing the Mind If that thought was a character how would you describe it? • Metaphors: Passengers on a bus, World’s greatest Storyteller , Masterful Salesman, Radio “Doom and Gloom”, The Bully, Word Machine.

15. Listening to the Mind • Saying the thought: (To yourself or Out loud) In a silly voice or to the tune of a song (Happy B-day) Changing inflection/pronunciation/slowly or really quickly • Saying thought Repeatedly : • Exercise: First Say Milk, Milk, Milk for 30 sec. Then use (unhelpful thought) saying 30 sec. • Done in a validating way to create space from literal meaning and to hold thought more flexibly.

16. Aware Processes

17. Present Moment Awareness(Mindfulness) • Paying attention to the direct external event and the psychological reactions it produces, with flexibility, openness and curiosity. • Open, Non-Judgmental, Compassionate, On purpose • Flexibly adjusting attention between the physical world outside of us and the psychological world within us.

18. Purpose and Goal of Mindfulness • Increased Awareness of thoughts, feelings and reactions. (Understanding present behavioral pulls) • Greater engagement in the moments that make up our lives. (Engaging in life beyond the limits of “mind”) • Decrease Suffering from what is not happening directly and greater workability with what “is.”

19. Developing Mindfulness • Formal ACT Mindfulness Exercises: (Dropping Anchor, Ten Breaths, Noticing 5 Things, Labeling) • Informal Mindfulness Practices (Mindful eating, walking, chores, making tea, etc.) *Notice internal/external experiences, let be, Notice what else shows up* • Practice Suggestions Find a time/place you can refrain from talking If using formal practice: Experiment with audio recordings Practice approx. 5 min. per day

20. Mindfulness (Defusion) Metaphors • Clouds drifting across the Sky • Waves washing onto the beach • Leaves on a Stream • Thoughts on a conveyor belt • Bubbles floating around

21. Self –as-Context • A sense of self that is a safe and consistent perspective from which to observe and accept all changing inner experience. • Goal: To help clients experience a part of self where internal experiences cannot harm them, define them or control their conscious choices. • Method: Metaphors, Mindfulness, “Defusive” Exploration

22. 3 Dimensions of Self • Self-as-Content: Perspective of feeling and thinking. • Self-as-Process: Perspective from which we Observe what we are feeling and thinking. • Self-as-Context: Perspective from which we notice that we are the place where thinking and feeling happens and we are the one’s observing it.